7 min read
Opinions expressed by PathLabEducation contributors are their own.
Do you tend to avoid using pathology testing in clinical practice? Do you think it is easier just to avoid it and rely on tried and tested treatments? Are you more comfortable with a “see how you go” approach? I’m here to show you 4 reasons why you can’t afford not to be using pathology testing in your integrative medicine practice.
I know from my own experience studying as a Naturopath, that pathology testing is not an area we cover particularly closely. I vaguely remember one or two classes where we were introduced to MOSBY’s guide to pathology testing, which was a great reference text, but not particularly useful practically.
As a student, I was always very interested in pathology testing and was always keen to read about the tests available on our Healthscope patient referral forms (little did I know that I would one day work for Healthscope! Life is funny :D).
For our student clinic group, the pathology testing referral forms were just another of the many forms that were available to students. But unfortunately we were never really taught how to use.
It wasn’t until I completed by undergraduate degree, and continued with postgraduate education and clinical practice, that I started to truly understand their value and recognize my own personal passion for them.
I find it very common to come across amazing practitioners who are still so uncomfortable with using and exploring pathology testing with their patients. More often than not, patients want testing. They want to see the facts in black and white, and they are usually more compliant as a result. Which brings me neatly to the first of our 4 reasons for using testing more in practice:
1. Patients want testing.
Believe it or not, most patients would prefer it if you referred them for some kind of testing. I found this out pretty quickly when I first started practicing as a Naturopath.
I always used to worry about the cost of testing or whether a GP would be happy to refer for bulk billed tests that I had suggested.
News flash! That’s not your problem. Those concerns should not stop you from recommending to a patient particular tests that you feel would improve their treatment outcomes.
Nine times out of ten they will let you know if they have concerns about being able to afford or perform testing, and if so, you cross that bridge when you get to it. Nine times out of ten, patients are happy to do the testing you recommend. Because it will give them answers, and that is what they are coming to you for right?
2. So many amazing tests!
It is amazing how many pathology testing companies are now providing Functional testing. More than ever, integrative practitioners such as Naturopaths, Nutritionists, Acupuncturists, Chiropractors, Herbalists, Osteopaths, Psychologists, Remedial and Musculoskeletal therapists etc. are able to refer for a vast array of different kinds of tests. Both General and Functional tests.
We no longer need to rely on referrals through a GP for patients to have useful testing performed. All you need do as a practitioner is sign up to one (or all) of the many pathology testing companies available to integrative practitioners here in Australia. Pathology companies simply need proof of your qualifications/association registration. Talk to your prospective pathology company for more details.
3. There are some things you just can’t figure out through clinical examination
We have all been there. A patient sitting in front of us with an extremely complex set of symptoms/case history. Clinical examination signs are hinting at a few things, but not telling you the whole story. And yet, often we will try to treat a patient without further investigation.
I have seen examples of this both in integrative and mainstream medical practitioners.
Whether it is to save time in order to get a patient feeling better quicker, or through a lack of confidence in choosing the right testing to help tell the patient’s story; both options are a short cut.
The short cut is never the right option. As practitioners, we must do our job and do what is best for our patients in the long run.
It’s important to understand that:
- You can treat patients symptomatically whilst having testing done. Easy.
- If you are not confident about which tests to refer for, ask for help, go out of your way to learn about them.
It’s your job and your responsibility to your patient. Understanding and using pathology testing in your practice makes you a better practitioner! Can you tell I’m passionate about this! 😀
4. Testing can tell you things you didn’t know you needed to know
One of the most useful aspects of testing is the fact it can uncover things that may not have occurred to you upon initial examination.
For example, a patient may present to you with unspecific gastrointestinal symptoms. They may say they feel worse for certain foods or their bowel motion isn’t great. It could be intolerances, it could be a latent gastro infection. It could be anything, who knows? But essentially you have a patient with gastrointestinal problems.
You could treat them symptomatically. Help them with fibre, probiotics, specific acupuncture Rx for the gut, laxatives etc.; and they may help somewhat.
But what if instead you did some testing. You referred them for stool testing such as the Complete Digestive Stool Analysis or a Faecal PCR. Often what comes back from testing may be expected, but sometimes it can be surprising what comes up. Like my patient who presented with what appeared to be, benign gastrointestinal symptoms, but upon testing it turned out that she had a Giardia infection. It turned out that she had passed on her Giardia infection to her family, and if it had been left undetected, could have impaired their health drastically.
Or the patient I saw who suspected she had a Candida bowel overgrowth which turned out to be Crohn’s Disease that was picked up through a Calprotectin stool test I referred her for.
You don’t know until you check. I often get asked, “what if the test results come back normal?“. For starters don’t always assume that there has been an issue with the lab! And secondly, this result can be just as valuable as a positive result. Test results that come back negative simply mean you are looking in the wrong place. Everything is healthy here, aetiology is somewhere else. Negative results require you to be a better detective. You will need to dig deeper into a patient’s health picture. Most likely further testing is going to unlock the answer. Sometimes a number of tests are necessary.
So instead of having tunnel vision and assuming that a patient has a particular problem, remember to think holistically. A test result that comes back with a negative result doesn’t mean you have chosen the wrong test. It means you have ruled something out as a potential cause. Sometimes testing can rule out something that you were certain was causing the problem.
Testing can be surprising like that.
Each test brings you closer to that answer. You don’t know what you are looking for until you find it!